Alcohol

5% of the people with hypertension probably have the disease because of alcohol. A number of studies have essentially proved that heavy drinking, more than three drinks a day, causes hypertension. This is a direct effect, independent of all the other factors leading to hypertension.

Heavy drinking can also lead to hemorrhagic stroke, a particularly devastating type of stroke: the blood vessels in the brain, weakened by years of hypertension, suddenly burst, flooding the brain with blood and destroying brain tissue.

Ironically, when a heavy drinker suddenly stops drinking, his or her blood pressure will surge upward. This is a temporary effect, and after a few weeks of not drinking, the blood pressure should go down considerably. This sudden surge of high blood pressure is very dangerous, especially for people over age 50. If you do have three or more drinks a day, make sure your doctor is informed and you are under his or her care when you stop. But do stop; the long-term effects of quitting alcohol will save years of your life, and not just by lowering your blood pressure.

Drinking excessive amounts of alcohol also works against therapies for hypertension. All of the positive actions you are taking to normalize your blood pressure - antihypertensive drugs, low-salt/high-potassium diet, exercise, weight loss - are hampered by continued drinking. It may even interact with your antihypertensive drugs. Alcohol is also a nutritional wasteland of empty calories and often leads you to snack on salty and fatty foods, both of which promote high blood pressure.

But there is glimmer of good news. Regularly drinking less than two drinks a day does not carry a rise in your blood pressure. And, strangely enough, recent studies have shown that moderate drinking of red wine is good for your cardiovascular system. Red wine increases the amount of good cholesterol, HDL, in your bloodstream. HDL carries fats out of your blood, reducing arteriosclerosis and your chance of undergoing a stroke. But remember, moderate drinking of alcohol means one to two drinks a day.